Genetic causes of Moyamoya are sickle cell disease [83,84], neurofibromatosis 1 [85], Noonan syndrome [86], Costello syndrome [87], Alagille syndrome [88], guanylate cyclase 1 soluble subunit alpha 1 (GUCY1A1) mutations [89], SAM domain and HD domain containing protein 1 (SAMHD1) mutations [90], Majewski syndrome [91], Turner syndrome [92], Down syndrome [93], and other causes. The gene discussed is SAMHD1; the disease is Down syndrome.